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Corneal cross-linking (CXL) with riboflavin (vitamin B 2) and UV-A light is a surgical treatment for corneal ectasia such as keratoconus, [2] PMD, and post-LASIK ectasia. It is used in an attempt to make the cornea stronger. According to a 2015 Cochrane review, there is insufficient evidence to determine if it is useful in keratoconus. [3]
Keratoconus (KC) is a disorder of the eye that results in progressive thinning of the cornea. [3] The protrusion of the cornea may result in blurry vision, double vision, nearsightedness, irregular astigmatism, [4] and light sensitivity leading to poor quality-of-life. [3] [5] [6] Usually both eyes are affected. [3]
Ulcerative vernal keratitis require surgical treatment in the form of debridement, superficial keratectomy, excimer laser therapeutic keratectomy, as well as amniotic membrane transplantation to enhance re-epithelialisation. Recently treatment with tacrolimus ointment (0.1%) used topically twice daily is showing encouraging results.
Corneal transplantation, also known as corneal grafting, is a surgical procedure where a damaged or diseased cornea is replaced by donated corneal tissue (the graft). When the entire cornea is replaced it is known as penetrating keratoplasty and when only part of the cornea is replaced it is known as lamellar keratoplasty.
Keratoconus, a progressive thinning of the cornea, is a common corneal disorder. Keratoconus occurring after refractive surgery is called Corneal Ectasia. It is believed that additional thinning of the cornea via refractive surgery may contribute to advancement of the disease [31] that may lead to the need for a corneal transplant.
Keratoconus in itself is a pattern of the entire cornea, therefore every measurement just focusing on one layer, might not be enough for a state of the art diagnosis. Especially early cases of keratoconus might be missed by a plain topographic measurement, which is critical if refractive surgery is being considered. [7]
The procedure results in a decrease in nearsightedness. According to the PERK study, 58% of eyes were corrected within 1.00D of goal 3 years after surgery. Additionally, 76% of eyes had uncorrected vision of 20/40 or better at 3 years. [5] From 2 to 10 years post-operatively 43% of eyes had an increase in farsightedness by 1.00D or more.
Pain is not typically present in pellucid marginal degeneration, and aside from vision loss, no symptoms accompany the condition. However, in rare cases, PMD may present with sudden onset vision loss and excruciating eye pain, which occurs if the thinning of the cornea leads to perforation. [1]